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Related Experiment Video

Updated: May 8, 2026

The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors
04:09

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Published on: February 13, 2026

Transanal endoscopic microsurgery: a new technique for completion proctectomy.

C Liyanage1, A Ramwell, G J Harris

  • 1St Richards Hospital, Chichester, West Sussex, UK.

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
|September 10, 2013
PubMed
Summary
This summary is machine-generated.

Transanal endoscopic microsurgery (TEMS) proctectomy offers a novel, safe approach for rectal stump management after colectomy. This technique may help selected patients avoid traditional abdominoperineal resection, reducing associated morbidity.

Keywords:
TEMScompletion proctectomyinflammatory bowel disease

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Area of Science:

  • Colorectal Surgery
  • Minimally Invasive Surgery
  • Surgical Oncology

Background:

  • The rectal stump after subtotal colectomy can cause complications.
  • Traditional abdominoperineal resection for completion proctectomy is associated with significant morbidity.
  • Restorative ileal pouch-anal anastomosis is standard for ulcerative colitis, but some patients require permanent ileostomy.

Purpose of the Study:

  • To describe a new technique for perineal proctectomy using transanal endoscopic microsurgery (TEMS) equipment.
  • To evaluate the safety and feasibility of TEMS proctectomy for managing the rectal stump.

Main Methods:

  • Twelve patients underwent TEMS proctectomy by a single surgeon.
  • The procedure involved intersphincteric dissection and rectal dissection using TEMS equipment.
  • Specimen extraction was performed perineally, followed by closure of the external sphincter and skin.

Main Results:

  • Nine patients had inflammatory bowel disease, two had neoplasia, and one had radiation proctitis.
  • The mean rectal stump length was 17.8 cm; the peritoneal cavity was entered in nine patients without small-bowel injury.
  • Median hospital stay was 5.5 days, with four cases of delayed perineal wound healing and no perioperative mortality.

Conclusions:

  • TEMS perineal proctectomy is a novel and safe technique.
  • This approach may be a viable alternative to traditional abdominoperineal resection in select patients.
  • Further studies are warranted to establish its role in rectal stump management.